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General NPI Number Information
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NPI Number | 1174855811
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Entity Type | Organization
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Legal Business Name | R TAYLOR KING, M.D.
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Dates
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Enumeration Date | 02/05/2010
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Last Update Date | 02/05/2010
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Provider Practice Location Address
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Address Line | 4237 SALISBURY RD STE 311
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City | JACKSONVILLE
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State | FL
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Zip | 32216-8089
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Country | US
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Telephone | 904-296-1044
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Fax | 904-296-3081
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Provider Business Mailing Address
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Address Line | 4237 SALISBURY RD STE 311
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City | JACKSONVILLE
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State | FL
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Zip | 32216-8089
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Country | US
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Telephone | 904-296-1044
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Fax | 904-296-3081
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICE TAYLOR KING
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Credential | M.D.
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Telephone | 904-296-1044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME4290
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License Number State | FL
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